


Choke

by curiouswildflower



Series: Trips, Trials, and Triumphs [2]
Category: Do No Harm (TV)
Genre: Discussion of Medical Things, Hurt/Comfort, Other
Language: English
Status: Completed
Published: 2017-06-29
Updated: 2017-06-29
Packaged: 2018-11-20 20:21:18
Rating: General Audiences
Warnings: No Archive Warnings Apply
Chapters: 1
Words: 2,238
Publisher: archiveofourown.org
Story URL: https://archiveofourown.org/works/11342541
Author URL: https://archiveofourown.org/users/curiouswildflower/pseuds/curiouswildflower
Summary: "Usnavi’s heart feels heavy and light at the same time, too big and too warm in his chest. He sings along, quietly but confidently, and when his voice cracks at the soaring height of the chorus no one pays any attention."





	Choke

**Author's Note:**

> An exploration of the process of diagnosing and dealing with a non-life-threatening but definitely life-changing disorder. Usnavi-centric. Fiercely personal. I'll explain more in the end notes if you want to know more. not beta-ed. Let me know if there's anything I should tag for.  
> Thank you for reading. <3

Vanessa sits on the rug on the other side of the coffee table from where Usnavi is leaning against Ruben on Nina’s couch, holding the guitar she’s been learning to play. Usnavi watches as the lights from the tree reflect off Vanessa’s hair hanging long and dark down her back. Her phone, sitting on the coffee table, lights up her face as she searches for the chords to any Christmas song requested of her. From the doorway into the kitchen Nina insists on _Oh Holy Night_ , and Usnavi’s breath catches at the scrunch of Vanessa’s eyebrows as she picks out the chords, the movement of her graceful hands against the guitar. She figures it out, nodding at Nina and they start singing.

Benny sings too, from where he’s draped across the adjacent armchair, half-empty mug of egg nog almost falling out of his loose hand. Carla and Daniela pick out harmonies sitting on the floor with Vanessa. Ruben taps a rhythm against his legs. 

Usnavi’s heart feels heavy and light at the same time, too big and too warm in his chest. He sings along, quietly but confidently, and when his voice cracks at the soaring height of the chorus no one pays any attention. 

\--

 

On a particularly warm day in mid-February, Benny invites him to the park to freestyle for old times sake. Usnavi lets himself into his aunt and uncle’s apartment to reclaim his radio from the mess of Sonny’s bedroom and beatboxes quietly under his breath as he walks to their bench. When he spots Benny he can see he’s doing jumping jacks, and he jogs the rest of the way.

“You ready for this?” Benny asks, shifting back and forth on his feet.

Usnavi fiddles with the radio, muscle memory guiding his cold fingers as he gets the station he wants. The sun on his shoulders feels warm through his coat and he scoffs at Benny’s taunt.

“I’ve been ready for years.”

Benny laughs and starts crooning along to the music almost immediately. Usnavi rolls his shoulders and shakes out his arms, letting the buzz of the beat settle into his brain. Words start to filter in, and he waits for Benny’s nod before he starts rapping.

They pass tight twos back and forth through a few songs, a long warm up for a game they haven’t played in years. By the middle of the third song they’re taking entire verses, and Usnavi’s throat starts to tickle. He realizes he forgot a bottle of water, clears his throat, and pushes out the first line of his next verse.

Only one song later his already raspy voice is crackling more than the radio and he has to stop.

“Sorry man,” he says, rubbing a hand over his mouth.

Benny shrugs, reaching down to shut off the stereo. “’S too cold out here anyway. You wanna make us coffee?”

Usnavi laughs. “Yeah whatever. If you insist.”

Benny picks up the radio and slings an arm around Usnavi’s shoulders, steering them toward the bodega.

\--

 

Usnavi gets sick off and on throughout March. He hates the way that his persistent cold makes his head feel – heavy and thick and slow. He has to start paying for tissues instead of stealing them from the bodega and he adds a decongestant to his pill case to take every morning and night with the rest of his medicine.

He gave up on his insistence that Ruben and Vanessa not kiss him – he doesn’t want them to be sick but eventually he misses their affection. Vanessa says his snoring on top of Ruben’s makes their bed unbearable at night. Ruben gives her a set of ear plugs with a bow on top at dinner and Usnavi laughs so hard he starts coughing.

By the time Sonny comes home for Spring Break Usnavi takes him up on his offer to run the store for a weekend. He spends both days in bed, doing little other than sleeping or having sex. His throat feels raw for a variety of reasons and he spends Sunday talking as little as he can manage.

Admittedly, it doesn’t go very well, but Usnavi has enough of a voice by Monday morning that he feels confident he can complete the socializing requirement of running the bodega.

\--

 

His persistent cold clears by April with the rest of the cold weather, which is good for him and good for his business and good for his partners.

Puzzlingly, his voice doesn’t really come back.

He notices it most in the bodega. His shouted greeting to the business man who stops in for his coffee and granola bar, his little _mhmm_ s at the new mom’s stories as she buys paper towels and ice cream – they all get stuck in his throat. They catch, those sounds, cracking and breaking or not coming out at all. Usnavi starts breathing deeper, talking louder, just to make them come out. It’s exhausting, and he finds himself paying more attention to his own breathing than to his customer’s stories and he feels shitty for more than one reason when he stumbles into his apartment that night.

And then it just… doesn’t go away. Days, weeks. Almost the entire month of April Usnavi finds himself choking on his words. By the time May comes he has no voice at all after a day spent working.

So, he becomes quiet. He nods more, he smiles and waves. He touches Ruben and Vanessa, hands and arms and faces, and tries to swallow his words. Chews at his cheeks, clears his throat, and shoves his words back into his lungs. When he’s home he sleeps – exhausted beyond comprehension with the effort of talking less.

Usnavi knew Ruben and Vanessa would notice. On a warm night in May they lay on a blanket on their roof – Usnavi tucked in between them as Vanessa traces patterns on his skin and Ruben traces constellations in the hazy sky.

“ _Querido_ ,” Vanessa starts, quiet with her chin tucked against Usnavi’s shoulder. “If something’s the matter – you would tell us, right?”

Usnavi clears his throat, shifts his legs nervously. Ruben curls his arm over Usnavi’s stomach.

“We love you, Navi. We want to help, if we can.”

Usnavi sits up suddenly. He scrubs his hands over his face, feeling the swell of words in his chest. He breathes out harsh through a sore throat, resists the urge to clear it again. He hears Vanessa and Ruben shift behind him, feels Vanessa’s cool hand scratch into the back of his hair.

“ _Carino, por favor. Que paso?_ ” Ruben whispers. Usnavi barks out a rough laugh, wet with the tears in his eyes.

“My voice.” He whispers. “My voice is…” he makes a floppy motion with one of his hands. He meets Ruben’s eyes. “It all gets stuck.” He touches his throat.

Ruben nods. “I was wondering if that was it. You’ve been so quiet.”

Usnavi nods, pulling his knees against his chest. Vanessa pokes him in the side. “Yeah. You’ve been too quiet. We miss your voice.”

Usnavi leans against her. “I miss it too.”

Ruben fidgets, drawing Usnavi’s attention. The moonlight shines dark blue on his hair, dances across the scars on his bare arms.

“I’ve done some research.” He admits. “There are a set of conditions called voice disorders. You’d get diagnosed by an ENT, and you’d have therapy with someone called a speech therapist.”

He looks down at his hands. “I think that’s what’s going on, Usnavi. I think it’s worth figuring out. And I can help pay for it all, if you want.”

Vanessa goes tense so subtly Usnavi can tell she was trying not to go tense. He feels her chest move as she breathes, and Usnavi nods. “I’ll go. We can figure out the money.”

Ruben deflates, like he was worried Usnavi would say no. Usnavi reaches out a hand and Ruben takes it immediately. 

“I want my voice back too.”

\--

 

Ruben goes with him to the doctor’s appointment three weeks later. Vanessa begs off, citing work and a general disinterest in being at the hospital. Later she admits to Usnavi that Ruben will know what the doctor’s talking about with far more clarity than she will, and Usnavi kisses her.

Ruben doesn’t say anything as Usnavi explains to the doctor what’s happening with his voice. The doctor says she wants to do something called a scope and asks permission before she sprays a gross numbing spray up Usnavi’s nose. He gags on the taste and flips Ruben off when he laughs at him.

The scope is a weird thin wire with a camera on the end that goes so far through Usnavi’s nose it looks down his throat. He, Ruben, and the doctor watch on the computer as the picture clears.

The doctor explains the anatomy, pointing out things like Usnavi’s epiglottis and tongue. He tries to pay attention, distracted by the weird full feeling of the scope in his nose. Ruben is practically out of his chair trying to get a closer look.

The doctor asks Usnavi to make a few different sounds, to sing a little. She pulls the scope out and sets it aside, then rewinds the video of the scope and explains.

They’re called vocal fold nodules. Or more commonly, nodes.

Bilateral nodes, here on his vocal folds. See those white bumps? Nodes are like calluses.

She turns to him, stern set to her eyes. “These are tiny, Usnavi. Believe me. Do not let anyone perform surgery on these. The surgery is risky and not worth it at this point.”

Usnavi nods, hands clenched in his lap.

She explains what Ruben mentioned on the roof – a speech language pathologist. Therapy once a week to teach him how to use a voice in a way that will make the calluses go away and will prevent them from coming back. Ruben asks a few questions, but Usnavi doesn’t have any.

His brain buzzes as they ride the train home. Ruben lets him lean against him, rubbing Usnavi’s hand with his thumb where it sits in his lap. Usnavi feels like he did when he was sick – his brain full and heavy, his lungs raw, his voice scratchy.

Usnavi sleeps for three hours when they get back to the apartment. He wakes up to the feeling of Vanessa climbing into bed with him. 

“ _Hey querido_ ,” she whispers. “Ruben told me what the doctor said.”

Usnavi finds he doesn’t have any words. He’s not choking on them, he’s not holding them down. He just doesn’t have any. Vanessa snuggles down next to him, wrapping an arm around his shoulders and twining their legs together. He can hear Ruben running water in the kitchen, maybe doing dishes. He closes his eyes and doesn’t fall back to sleep, but he doesn’t try to stay awake either. He floats, lost in the spiral of his thoughts.

He did this to himself. He used his voice wrong. He talked too much, too loud, too excited. He sang too much, rapped too much. He pushed his voice. He ruined his voice. And now he – _or Ruben, more likely_ – has to pay for rehabilitation therapy. He has to pay for the train to the hospital. He has to pay someone to teach him how to use his voice in a way that doesn’t cause him harm.

He curls a hand into Vanessa’s hair and finally cries. It doesn’t make his throat feel any better, but it makes his heart feel lighter. Vanessa squeezes him tighter, rubbing her hand on his back. Ruben appears in the doorway, damp sleeves and damp cheeks. He pushes up behind Usnavi and kisses his neck. Dinner is soup, and after they sleep.

\--

 

Therapy is hard. He goes all summer, once a week closing the bodega early to make it to the hospital during their business hours. His speech pathologist is kind, young and knowledgeable and encouraging. After she teaches him techniques, safer ways to use his voice, they spend almost every session making small talk so he can practice. Sometimes he brings Ruben with, or Vanessa, to practice with someone else. 

He breaks down in tears at least once a week, at therapy or outside of it, desperate to have his voice back. Exhausted with the task of changing how he talks every time he talks. _Move his resonance out of his throat_ and _smooth his way into vowels_ \- reminders that hum in his head constantly.

The doctor scopes him again in September and shows him how his nodes have flattened out. “They’re still there,” she cautions him, “but they’ve improved. You can stop with therapy, but if you keep up those techniques you’re learning these could go away completely.”

Usnavi thanks his doctor, thanks his speech therapist, but he knows he’s grateful to not see them anymore.

\--

 

Another night spent sitting on the roof, chilly in early October. Vanessa brings her guitar, Ruben looking up songs he wants her to play. Usnavi doesn’t sing all the songs, but he sings to some and raps to others and when he falls asleep his voice isn’t raw. He doesn’t choke on his words, he doesn’t shove them down into his chest. They come out different, but they come out. Vanessa and Ruben pepper his face with kisses and he laughs his squeaky laugh and his heart feels heavy and light at the same time.

**Author's Note:**

> So, this is closely based on personal experience. I have vocal fold nodules, and I based this largely on what it was like for me to figure out that I had a problem and go through with getting it diagnosed. (and if you remember, Lin has/had some vocal fold problems too). I'm actually also finishing my graduate degree in speech language pathology, so I know about nodes from the therapy perspective too. Let me know if you have any questions about my experience or Usnavi's.
> 
> Thank you so much for reading, let me know what you thought. <3  
> (I'm maeflowerpetunia on tumblr)


End file.
